Anywhere a large crowd congregates, the need for a well-prepared emergency medical team is present. To provide the best possible service to their communities, it is essential that EMS agencies covering concerts and other large gatherings take all the risk factors into consideration and make sure the proper equipment and resources are in place to address all potential scenarios.
MONOC EMS, headquartered in Wall, NJ, provides standbys as well as active MCI-style response to a wide spectrum of events. These include small gatherings like funerals, health fairs, sporting competitions and community events, which require only single BLS units, and larger crowds such as at concerts and theme parks, involving thousands of people.
In both scenarios, it is important to be prepared for the worst, because you never know what you'll get. The overcrowded heavy-metal concert may prove to be completely uneventful, while the small-town bingo game can yield more patients than ever imagined. Either way, it's imperative to have all potentially needed equipment at the ready, even if it's not directly on site. If your service takes on the responsibility of such events, you'll be squarely in the public eye--either making positive, professional impressions, or rubbing people the wrong way.
There are several important factors to keep in mind when taking on special event work:
Professional appearance: It is imperative that staff look professional. If climate and conditions permit, it's a good idea to utilize Class A dress uniforms. (Of course, if it's expected to be 90-degree weather with 95% humidity, opt for the cooler short-sleeve shirts.) Short pants, regardless of weather, are a bad idea: EMS providers will be working outdoors, kneeling on pavement, gravel, etc. Shorts can be a certain knee-scraper. Some services use alternative uniforms for special events, but this can be counterproductive--if an employee fails to show up, a supervisor will have to find a replacement with the proper uniform, which may not have been furnished to all employees. Another point to consider is that regular duty uniforms were developed to display an agency's patches and certifications, and represent the image the service wants to portray to the public. Using an inexpensive golf-type shirt defeats this purpose.
Drugs/alcohol: At events where alcohol is served, you might expect to encounter injuries from fights, falls, etc., as well as cases of acute intoxication. Plans must be in place for utilizing security staff or the local police. Often, a mere police presence can help persuade uncooperative patients to go to the hospital. Concert EMS staff should be educated on ways to assess and treat patients who have overdosed on street and designer drugs such as LSD, PCP, ecstasy, GHB or even nitrous oxide. There have also been cases where concertgoers have maliciously exposed EMS providers, police and security to drugs. Therefore, inform staff to be extremely cautious to not accept food or water from the public, allow themselves to be sprayed, etc.
Specialized equipment: Different events require different equipment. For example, to provide emergency services at an offshore powerboat race, it is necessary to provide staff with personal flotation devices and waterproof radio protectors. At the local auto track, they'll need hearing and eye protection, turnout gear and shoes with oil-resistant soles. At a nighttime event with a large crowd, it is a good idea to give providers small chemical light sticks that attach to uniforms with safety pins. These serve a couple of purposes: They help the public quickly identify EMS providers if they're needed, and they can serve as safety beacons for providers needing assistance. It can be difficult to identify exact locations in calling for help over the radio; light sticks can be easily picked out of a large crowd.